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Walk and Talk Therapy Liability Waiver / Informed Consent Form

I, , have opted to receive Walk & Talk Therapy offered by Laura Fischetti, LMHC. Walk & Talk Therapy is a form of therapy that incorporates walking while talking about issues and problem-solving. I recognize that complete confidentiality cannot be maintained in this venue, and I accept the possibility that other people may hear parts of my conversation, I acknowledge that my enrollment and subsequent participation is purely voluntary and in no way required by Laura Fischetti, LMHC.

In consideration of my participation in this form of therapy, I, , hereby release Laura Fischetti, LMHC, from any claims, demands, and/or causes of action as a result of my voluntary participation.

By signing, I hereby affirm that I have read and fully understand the above statements.

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June 21, 2021 2:59 pm PST

Walk and Talk Therapy Liability Waiver / Informed Consent Form Uploaded by Laura Fischetti - counseling@epiclifechurch.org IP 50.52.19.45